That data comes from the latest polling from Gallup, which confirms the widening gulf between red states and blue states when it comes to health coverage. This divide existed before health reform went into effect; however, it’s only gotten worse under Obamacare, which has helped the national uninsurance rate plunge to record lows but which has been implemented unevenly across the country.

States that have worked to fully implement Obamacare — which involves agreeing to both accept the law’s optional Medicaid expansion and set up their own insurance marketplaces — have seen the largest drops in their uninsurance rates over the past six months. According to Gallup, the biggest success stories in this area are Arkansas and Kentucky, which have both nearly cut their percentage of uninsured residents in half. In some counties in Kentucky, the uninsurance rate fell from more than 20 percent before Obamacare to just five percent after the law’s provisions took effect.

But the GOP-led states that have resisted Obamacare at all costs aren’t experiencing the same gains. Their uninsurance rates are falling at a much slower rate. “The already notable gap between the two groups of states widened through the first quarter to 4.3 points, as states that have implemented these core mechanisms of the Affordable Care Act reduced their uninsured rates three times more than states that did not implement these core mechanisms,” Gallup researchers explain.

To make matters worse, the states that have refused to embrace Obamacare are the same ones that could have benefited from it the most. Those states had higher uninsurance rates to begin with, and they’re home to people who tend to be poorer and sicker than the residents in other states. In that context, it’s not entirely surprising that the 10 states that currently have the highest percentages of uninsured residents — Texas, Mississippi, Georgia, Florida, Louisiana, Montana, Arizona, Oklahoma, Alaska, and New Mexico — are led by GOP politicians. Although some lawmakers and grassroots activists in those states have pushed for Medicaid expansion, they’ve ultimately been blocked by Obamacare opponents, and none of those states are fully implementing health reform in 2014.

Thanks to the ongoing political resistance to Obamacare, about six million people have been locked out of health reform altogether, left unable to qualify for either public insurance or federal assistance to purchase private insurance. States’ refusal to expand Medicaid is disproportionately harming low-income people of color, who stand to benefit most from the policy.

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